Individual
MRS. JACKLYN MICHELLE JOLLY LESSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6355 WALKER LN STE 401, ALEXANDRIA, VA 22310-3250
(703) 924-2100
(703) 922-6067
Mailing address
3172 HARVARD ST, WOODBRIDGE, VA 22192-1727
(703) 475-9182
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024179783
VA
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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